đź“„ Required Emplyee Documents (A & B)

Appendix A – Mandatory Certificates

Appendix B – Contractor Requirements

  • Group membership authorization
  • Employee resume
  • Contractor Application Personal Information 
  • Employee / Contractor Agreement
  • Employee Responsibilities / Independent Contractor
  • Job Description
  • W-9
  • Ethics Code
  • Affidavit of Good Moral Character
  • Attestation of Compliance Background Screening
  • AHCA Level II Fingerprints (Expires every 5 years)
  • Privacy Policy Acknowledgement Form
  • Non-Institutional Medicaid Provider Agreement
  • Employment Eligibility Verification (E-Verify) (I-9)
  • Non- Transportation Agreement
  • Payment Terms and Conditions
  • Provider Number (Medicaid Letter)
  • BACB certification/re-certifications (BCBA, BCaBA, RBT)
  • 40-hour Training Certification (ONLY RBT’S)
  • High school diploma, College degree/diploma
  • Police Record (Must be within 90 days of hiring date.) Request at Hillsborough County Sheriffs Office- 1238 Tech Blvd, Tampa, FL 33619
  • Valid Driver’s License (Color Copy Front and Back)
  • Social Security Card (Colored Copy and Signed)
  • 2 Recommendation Letters (In English)        
  • Liability insurance
  • Car Registration + Insurance (Valid)
  • Physical exam (Must include TB Test)
    • Aguilas International Technical Institute: 225 W Busch Blvd, Tampa, FL 33612
  •  Cheque Void + Employer identification number + Sunbiz